Question on sublinguals and injections.

[Betterdayz]

I’ve been taking monthly injections since March ‘17 but still have symptoms before my next shot. Is it ok to take 3000mg sublingual daily to maintain? Or should it be taken once per week if you’re on monthly injections?

I know it may vary from person to person and one should probably measure based off of the severity and type of symptoms exhibited, but just wanted to hear your thoughts since there’s so much contradicting information out there that it’s just becoming confusing.

Also, I’m not sure what type of B12 injection I get (methyl, cyano, etc?), but just took my first cyano sub today. I just read that methyl is better so should I discard the cyano and use methyl instead if it’s in fact ok to use while on monthly injections?

Thanks in advance for your input and support!

[clivealive Forum Support]

Hi Betterdayz are you in the U.K?

it is perfectly safe to "mix and match" between cyano, methyl and hydroxo.

I've been on cyanocobamalin 1mg injections every month for over 46 years and I also use a methylcobamalin spray daily in between and I'm still "clivealive" aged 77

[Betterdayz in reply to clivealive]

Thank you Clive! Love seeing your reassuring comments on here!

[Betterdayz in reply to clivealive]

Oh, and sorry, I’m in the US

[fbirder]

Cyanocobalamin is cheaper, more stable and easier to obtain than methylcobalamin. It is also just as, if not more, effective.. ncbi.nlm.nih.gov/pubmed/258...

To be absorbed sublingually a molecule needs to be small and lipophilic (fat-soluble). B12 is large and lipophobic (fat-insoluble). That’s why they do nothing for me.

Some people say that 1% of an oral dose of 1000 mcg is absorbed. However, I’ve not been able to find any study that shows this that has been done in people with Pernicious Anaemia. The subjects of the studies used to reach this number just had low B12 - which may have been down to diet.

Interestingly, I have found a paper that says that the IF-mediated absorption of B12 is saturable. The most B12 that can be absorbed, by a normal person, in a single meal is just over 10 mcg.

10 mcg is exactly 1% of 1000 mcg. So 10% of an oral dose of 1000 mcg will be absorbed by a normal person with no PA, no absorption problem, no B12 deficiency. Even more reason to doubt the ‘high-dose oral is as good as injections’ nonsense.

[Gambit62 Administrator]

high dose sublingual/oral (not much difference between absorption for the two) can be effective in maintaining levels but unlikely to be useful for raising levels if you have an absorption problem. As such - starting just after an injection would be best.

The stuff about methyl being better is more hype and very little fact - no clear evidence that it really is any better and as fbirder says it's less stable and more expensive.

See if it works and take the frequency from how it affects your symptoms

[Betterdayz in reply to Gambit62]

I believe part of my absorption issue may have stemmed from taking Prilosec 40mg for over a year so my stomach isn’t producing enough acid for the absorption. I stopped taking it as of yesterday as it’s not really doing much for me anyway (my doc even said it’s not much use but I still take it since it’s been my routine I guess).

My injection was last Wednesday and just took my first sub yesterday so hopefully that isn’t dreadfully late. Do you think 2 tabs may be more effective to maintain instead? Or is it best to not exceed the recommended daily max of 1? I read someone else took 5 1000mg subs a day in another thread, so what if I took two 3000mg subs?

[Gambit62 Administrator in reply to Betterdayz]

people vary so much that you just have to try it and see

I am at the high end of supplementing as my symptoms come back within 24 hours if I don't but you really need to be driven by what is going on with your symptoms